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Agony and Ecstasy

Party Drug or Breakthrough Treatment for PTSD?

By Amy B. Dounay, Lori L. Driscoll, Phoebe M. Blessing, Hallie M. Comfort, Joshua M. Mares

Agony and Ecstasy


 

Abstract

This interrupted case study explores the scientific, legal, and societal complexities of repurposing an illicit substance, 3,4-methylenedioxymethamphetamine (MDMA), also known as "Ecstasy" or "Molly," into a clinically accepted medicine for treating post-traumatic stress disorder (PTSD).  Students first learn about the neuroanatomical basis for PTSD and its clinical distinction from anxiety and depression, and then critically evaluate the benefits and risks of a selective serotonin reuptake inhibitor (SSRI), sertraline (brand name Zoloft), in comparison with MDMA.  The activity concludes with a panel discussion in which students assume the roles of various clinical and regulatory experts to recommend the best treatment option for the character described in the case narrative. Students will learn to identify benefits and risks of an approved medicine by reading its drug label and to critically evaluate human clinical data published in primary literature.  This case has been used in undergraduate medicinal chemistry and neuropharmacology courses and is suitable for a variety of introductory undergraduate or graduate courses in psychology, biochemistry, pharmacy, public health, and biomedical sciences.

   

Date Posted

03/16/2017

Overview

Objectives

  • Describe the causes, symptoms, prevalence, and current treatments for PTSD.
  • Understand how the actions and effects of psychoactive drugs relate to the anatomy and pharmacology of the nervous system.
  • Compare and contrast the primary pharmacology of sertraline and MDMA.
  • Understand the Drug Enforcement Agency (DEA) drug scheduling system and its impacts on pharmaceutical access and research.
  • Identify the potential benefits and risks of an approved pharmaceutical agent by reading its drug label.
  • Critically evaluate the pharmacological and clinical rationale for using MDMA to treat PTSD and make an informed decision regarding this controversial treatment.
  • Explain general guidelines and objectives for phase I, II, and III clinical trials.
  • Evaluate challenges and limitations of human clinical studies and critically evaluate clinical data published in primary literature.
  • Practice translating technical information from primary literature into a language that a lay person can interpret and comprehend.

Keywords

PTSD; pharmacology; ecstasy; risk-benefit analysis; drug; clinical trial; drug enforcement agency; DEA; sertraline; medicine; FDA; SSRI; psychotherapy

  

Subject Headings

Biochemistry
Interdisciplinary Sciences
Medicinal Chemistry
Medicine (General)
Neuroscience
Pharmacy / Pharmacology
Psychology
Public Health

EDUCATIONAL LEVEL

Undergraduate lower division, Undergraduate upper division, Graduate, Professional (degree program), Clinical education

  

FORMAT

PDF, PowerPoint

   

TOPICAL AREAS

Ethics, Policy issues, Regulatory issues, Social issues

   

LANGUAGE

English

   

TYPE/METHODS

Analysis (Issues), Discussion, Interrupted, Journal Article, Role-Play

 

 

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